Provider Demographics
NPI:1962168005
Name:ADVANCED PAIN MEDECINE INSTITUTE
Entity type:Organization
Organization Name:ADVANCED PAIN MEDECINE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REZA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHORBANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-220-1333
Mailing Address - Street 1:PO BOX 71155
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20813-1155
Mailing Address - Country:US
Mailing Address - Phone:301-220-1333
Mailing Address - Fax:
Practice Address - Street 1:7501 GREENWAY CENTER DR STE 690
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3514
Practice Address - Country:US
Practice Address - Phone:301-220-1333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED PAIN MEDECINE INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty